Endovascular therapy for critical limb ischemia

AbstractChronic critical limb ischemia (CLI) occurs when arterial perfusion is reduced below a threshold level that results in rest pain and/or tissue breakdown in the lower extremities. Importantly, it is associated with high cardiovascular morbidity and mortality. Without prompt revascularization, CLI may result in loss of a limb (i.e. amputation) and/or life. The goal of endovascular therapy is the re-establishment of pulsatile, straight-line flow to the distal extremity. Percutaneous transluminal angioplasty (PTA) has been shown to be effective and safe in the setting of CLI, with limb salvage rates that compare favorably with surgical procedures. Stents are indicated for failed PTA, while adjunctive therapies such as lasers, thermal angioplasty and atherectomy devices lack data demonstrating improved efficacy compared with conventional lower extremity interventions. In addition to successful revascularization, the institution of lifestyle changes, atherosclerotic risk factor modification, and pharmacologic therapies are indicated to reduce cardiovascular morbidity and mortality.     

An Effective Method for Segmentation of MR Brain Images Using the Ant Colony Optimization Algorithm

Since segmentation of magnetic resonance images is one of the most important initial steps in brain magnetic resonance image processing, success in this part has a great influence on the quality of outcomes of subsequent steps. In the past few decades, numerous methods have been introduced for classification of such images, but typically they perform well only on a specific subset of images, do not generalize well to other image sets, and have poor computational performance. In this study, we provided a method for segmentation of magnetic resonance images of the brain that despite its simplicity has a high accuracy. We compare the performance of our proposed algorithm with similar evolutionary algorithms on a pixel-by-pixel basis. Our algorithm is tested across varying sets of magnetic resonance images and demonstrates high speed and accuracy. It should be noted that in initial steps, the algorithm is computationally intensive requiring a large number of calculations; however, in subsequent steps of the search process, the number is reduced with the segmentation focused only in the target area.     

Childhood Apraxia of Speech (CAS) in two patients with 16p11.2 microdeletion syndrome

We report clinical findings that extend the phenotype of the ∼550 kb 16p11.2 microdeletion syndrome to include a rare, severe, and persistent pediatric speech sound disorder termed Childhood Apraxia of Speech (CAS). CAS is the speech disorder identified in a multigenerational pedigree (‘KE'') in which half of the members have a mutation in FOXP2 that co-segregates with CAS, oromotor apraxia, and low scores on a nonword repetition task. Each of the two patients in the current report completed a 2-h assessment protocol that provided information on their cognitive, language, speech, oral mechanism, motor, and developmental histories and performance. Their histories and standard scores on perceptual and acoustic speech tasks met clinical and research criteria for CAS. Array comparative genomic hybridization analyses identified deletions at chromosome 16p11.2 in each patient. These are the first reported cases with well-characterized CAS in the 16p11.2 syndrome literature and the first report of this microdeletion in CAS genetics research. We discuss implications of findings for issues in both literatures.     

Correction: The β-cyclodextrin-modified nanosized ZSM-5 zeolite as a carrier for curcumin

Correction for ‘The β-cyclodextrin-modified nanosized ZSM-5 zeolite as a carrier for curcumin’ by Shahin Amani et al., RSC Adv., 2019, 9, 32348–32356, DOI: 10.1039/C9RA04739E.

The authors regret that the names of the authors were listed incorrectly in the original article. The corrected author list is as shown above.The Royal Society of Chemistry apologises for these errors and any consequent inconvenience to authors and readers.     

Fascial Repair of Laparoscopic Ports with Allis–Hemostat Technique

Port site hernias are one of the most serious complications associated with laparoscopic surgery. In this study, we present a simple and reliable method for port site closure in laparoscopic surgery. From 2005 to 2011, 500 patients who underwent laparoscopic surgery were enrolled for the study. They were evaluated considering age, sex, indication of laparoscopic surgery, and early and late complications of port site and were followed up at least for 1 year after the surgery. In our study, 180 males and 320 females with mean age of 36 years were enrolled. The most common indication for laparoscopic surgery was cholecystectomy in 320 patients (64 %). There were no early or late complications of port site after surgery. Our method is a new modification of the procedure presented by Spalding. Using Allis forceps and putting it under the fascia seems to be a more suitable technique which facilitates the laparoscopic port repair. We found it to be extremely safe, simple, and easy to teach.     

Correlation between expression of MMP-9 and MMP-3 in Helicobacter pylori infected patients with different gastroduodenal diseases

Background and study aims

Helicobacter pylori (H. pylori) has been implicated in the pathogenesis of most important gastro-duodenal diseases, such as gastritis, peptic ulcer disease (PUD) and gastric cancer. H. pylori upregulates the expression and activity of several matrix metalloproteinases (MMPs) in the gastric mucosa, but the role of MMP-3 and MMP-9 in infected patients with H. pylori have not been clearly defined yet. We examined mucosal MMP-3 and MMP-9 mRNA levels in gastric mucosa of H. pylori infected patients and evaluated the effects of virulence factors cagA and vacA allelic variants on these levels. We also determined correlation between mucosal MMP-3 and MMP-9 mRNA levels and types of disease.